Getting Insight into Factors Limiting Healthy Dietary Choices
What influences our meal choices? Researchers from the Netherlands attempted to answer this question. They hypothesized that socioeconomic status might be involved.
Kamphuis and colleagues conducted face-to-face interviews among 399 adults (mean age 63y) participating in the Health and Living Conditions in Eindhoven and surrounding cities (GLOBE) cohort study. Five meal attributes (taste, healthiness, preparation time, travel time to shops, and price) were assessed with 3 or 4 levels for each attribute.
Taste and healthiness were subjective rated with stars or checks. Discrete values were given for dinner cost (2 or 6 euros), preparation time (0 or 30 min), and travel time (5 or 20 min). The most important factors influencing food choices were, in descending rank order: healthiness of the meal, acceptable taste, cost, travel time to shops, and preparation time. Individuals with lower income valued factors with subjective ratings (healthiness and taste) less than factors with discrete comparisons of (price, travel time, prep time).
Healthiness was rated ~4.5 times more important than the second variable (taste). It isn’t surprising that people would rank healthiness high. The real question is: can we consistently make healthier food choices? If not, why not?
Dietary choices are influenced by: individual preferences (sociocultural, psychological and physiological factors), the food (flavor, aroma, texture, appearance), and the environment (cultural, social, economic and physical factors). Nutrition labeling may be perceived differently by socioeconomic group but overall food consumption isn’t significantly affected under experimental conditions. Point of sale nutrition information doesn’t affect nutrient intake (Hoefkens et al) although the healthiest choices are made by individuals with the most nutrition knowledge, openness to changing meal choices, and the strongest health and weight-control motives. What can one conclude from these studies?
Better, more objective data is needed to assess nutritional status. The 2014 Food & Health Survey by the International Food Information Council finds that consumers are nutrition knowledgeable. When asked questions about health and nutrition, I believe people want interviewers to be positively impressed. We want people to approve our actions. Because we want their approval, we may exaggerate. The tendency to under-report dietary energy intake and over-report physical activity. It is called recall bias.
Recall bias distorts scientific research and confounds policy-makers. It is time to adopt objective measures, biochemical assessments of nutritional status (see CDC Second Nutrition Report). These should be correlated with objective measures of household income, education level, home address, etc. Then educational programs and policies can be put in place to address socioeconomic, cultural and environmental factors affecting dietary choices and constraining health.
Kamphuis CBM, de Bekker-Grob EW, van Lenthe FJ. Factors affecting food choices of older adults from high and low socioeconomic groups: a discrete choice experiment. 2015 Am J Clin Nutr doi: 10.3945/ajcn.114.096776
Mak AHN, Lumbers M, Eves A, Chang RCY. Factors influencing tourist food consumption. 2012 Int J Hosp Management doi: 10.1016/j.ijhm.2011.10.012
Hoefkens C, Lachat C, Kolsteren P, Van Camp J, Verbeke W. Posting point-of-purchase nutrition information in university canteens does not influence meal choice and nutrient intake. 2011 Am J Clin Nutr doi: 10.3945/ajcn.111.013417
Crockett RA, Jebb SA, Hankins M, Marteau TM. The impact of nutritional labels and socioeconomic status on energy intake. An experimental field study. 2014 Appetite doi: 10.1016/j.appet.2014.05.024
Dhurandhar NV, Schoeller D, Brown AW, Heymsfield SB, Thomas D, Sorensen TIA, Speakman JR, Jeansonne M, Allison DB, and the Energy Balance Measurement Working Group. 2014 Int J Obesity doi: 10.1038/ijo.2014.199